Indoor mask mandates will be back in Multnomah County starting Friday, August 13, and extend perhaps through January 2022, Multnomah County Chair Deborah Kafoury announced Monday at a press conference flanked by representatives from the region’s major hospital systems.

The county is the first in Oregon to put an indoor mask mandate—regardless of vaccination status–back into place, despite having one of the highest vaccination levels in the state. Seventy-five percent of adults in the county have been vaccinated, and while cases have been rising in the metro area, the spread is even more prevalent in southern and eastern Oregon, where vaccination levels aren’t as high.

“This represents an urgent pivot in what we can and must do while we continue to get our community vaccinated,” Kafoury said Monday.

Multnomah County joins a handful of other counties around the nation, including Los Angeles County, that have put indoor mask mandates back in place in recent weeks.

Doctors from OHSU, Kaiser Permanente, the Legacy system and the Providence Health system said that the current surge of COVID-19 infected patients, including those from around the state who are diverted to the metro area's larger hospitals, has local emergency rooms packed full, leading to long waits and potentially imperiling the ability of hospitals to care for patients who come in with heart attacks, strokes and other serious issues. Hospitals have also been struggling with staffing shortages, as exhausted health care workers head for the exits after nearly a year and a half of pandemic workload.

Failure to wear masks indoors in Multnomah County could ultimately result in a fine of up to $1,000, Kafoury says, with further details about enforcement coming later this week. The county is setting up a hotline for residents to call in about potential violations.

Vaccine mandates for public employees, meanwhile, remain under discussion. A quirk in Oregon law allows broad vaccine mandate exemptions for health care workers, firefighters, police and corrections officers, though Gov. Kate Brown recently mandated that all health care workers either get vaccinated or be tested weekly for Covid-19.  Kafoury is also asking Gov. Kate Brown to expand that directive to include all corrections and law enforcement workers, a group whose vaccination levels have consistently been lower than the general public.

Portland Public Schools superintendent Guadalupe Guerrero said Monday that the district had made no decision yet about mandating vaccines for its employees. Doctors present at Monday’s press conference universally agreed that the best way to protect unvaccinated children is for all adults around them to be vaccinated.

Guerrero pointed out that the “vast majority” of district employees have been vaccinated, and, with schools set to open on September 1, added that the district is considering an initiative that would allow parents to know what percentage of teachers and staff in their child’s school have been vaccinated.

Multnomah County Health Office Jennifer Vines said Monday that the county has yet to pinpoint the specific metrics that would allow the indoor mask mandate to be lifted. Nor has the county defined how much worse things might have to get before other restrictions—such as distancing and capacity limits on businesses—would have to be put back in place, though Kafoury said all options are under discussion.